Ultrasound-Guided Core Biopsy of Breast Lesions in a Resource Limited Setting: Initial Experience of a Multidisciplinary Team (original) (raw)
Related papers
Ultrasound-guided core-needle biopsy of breast lesions
Insights Into Imaging
Objective To review the role of ultrasound-guided core-needle biopsy (CNB) in the management of breast lesions. Methods Review of the most relevant literature on this topic. Results This technique shows a high sensitivity value of about 97.5% and it offers many advantages over other imaging techniques to guide a biopsy: non-ionising radiation, low cost, full control of the needle in real time, accessibility in difficult locations, multidirectional punctures and excellent comfort for patients and radiologists. All of these advantages have made this technique the most widespread used to perform a biopsy for a suspicious breast lesion. The most important limitation is the failure to perform a biopsy for lesions that are not seen on ultrasound. An adequate radiological–pathological correlation is necessary to minimise the false-negative results. Conclusion Ultrasound-guided CNB has proven to be a reliable technique for performing a biopsy for breast lesions that can be clearly seen on ultrasound.
The Revisited Role of Ultrasound Guided Core Needle Biopsy in the Breast Cancer Diagnosis
Chirurgia (Bucharest, Romania : 1990)
Core needle biopsy (CNB) is an alternative to surgical biopsy in establishing the histopathological diagnosis of mammary lesions. The aim is to determine the accuracy of ultrasound guided CNB (US-CNB) in establishing breast cancer diagnosis. We retrospectively analyzed the data of US-CNB patients between May 2012 - December 2014. One hundred sixty-three biopsies were performed in 155 patients. To assess the diagnostic accuracy of US-CNB, the results were correlated with the gold-standard of surgical excision of the breast lesions, thus, 90 patients (94 breast lesions) were included in the study group. We calculated the concordance of the results using the Kappa Coefficient, sensitivity and specificity using the ROC curve and the false-negative rate. US-CNB identified 74 (79%) malignant lesions, 1 (1%) precursor high-risk lesion, and 19 (20%) benign lesions. Concordance between histopathological results was 96.8% (kappa: 0.91). The 94.2% (kappa: 0.80) consensus of the histological ty...
Ultrasound-Guided Core-Needle Biopsy of Suspicious Breast Lesions
Journal of Interdisciplinary Medicine, 2020
Background: Breast cancer is the female cancer with the highest mortality. While early detection is a public health priority in Western European countries, a screening program in our country has yet to be implemented. The best diagnostic accuracy is achieved through the use of triple assessment: clinical examination, imaging, and core-needle biopsy where indicated. Prognosis is influenced by clinical, histological, and biological factors, and therapy is most effective when individually tailored. Aim of the study: To analyze the clinical, histological, and immunohistochemical characteristics of the biopsied nodules and summarize our experience from the last three years. Material and Methods: We retrospectively analyzed data from 137 patients who underwent core-needle biopsy between 2017 and 2019. Imaging score was assigned based on ultrasound examination or mammography. Clinical and pathological parameters were recorded, followed by statistical processing of the data. Results: The me...
Insights into imaging, 2018
This article summarises the information that should be provided to women and referring physicians about breast ultrasound (US). After explaining the physical principles, technical procedure and safety of US, information is given about its ability to make a correct diagnosis, depending on the setting in which it is applied. The following definite indications for breast US in female subjects are proposed: palpable lump; axillary adenopathy; first diagnostic approach for clinical abnormalities under 40 and in pregnant or lactating women; suspicious abnormalities at mammography or magnetic resonance imaging (MRI); suspicious nipple discharge; recent nipple inversion; skin retraction; breast inflammation; abnormalities in the area of the surgical scar after breast conserving surgery or mastectomy; abnormalities in the presence of breast implants; screening high-risk women, especially when MRI is not performed; loco-regional staging of a known breast cancer, when MRI is not performed; gui...
Ultrasound-guided biopsy of palpable breast masses
European Journal of Ultrasound, 1997
Objecti6e: Breast ultrasound and US-guided interventional procedures of the breast are increasingly being applied and integrated in the diagnostic work-up and management of breast patients. The aim of the study was to assess the reliability of ultrasound-guided (US-guided) needle core biopsy of palpable breast masses with a 1.2 mm needle (18 gauge) in a fully automated firing device as an alternative to the existing surgical routine, i.e. surgical excision or palpation-guided Tru-Cut biopsy with a 2.0 mm needle (14 gauge) in a semi-automated device. Method: US-guided biopsy of palpable breast masses was prospectively, consecutively and openly compared to open surgical biopsy in a design closely connected to the routine diagnostic work-up of these patients. Results: 106 Patients with a palpable mass in one of their breasts were included in this study. The final diagnosis was the histological result of the open surgical biopsies, which were: 49 malignant lesions, 14 fibroadenomas, and 43 cases of fibrocystic disease. Forty-six malignant tumors were detectable ultrasonically and US-guided biopsy was performed, yielding adequate and correctly positive diagnoses in 41 cases (89%). Three US-guided samples were adequate for diagnosis but yielded a false-negative result. Two samples were excessively fragmented and thus inadequate for diagnosis. All 14 fibroadenomas were correctly diagnosed ultrasonically and US-guided sampling yielded a correct diagnosis in all but one case which was inadequate. The remaining 43 cases showed no abnormality on the sonogram and open biopsy yielded fibrocystic disease. Conclusion: US-guided biopsy of palpable breast masses can obviate open surgical biopsy whenever a mass is ultrasonically visible and it is strongly advocated to implement the procedure in the diagnostic work-up of these patients. © 1997 Elsevier Science Ireland Ltd.
Role of Breast Ultrasound for the Detection and Differentiation of Breast Lesions
Mammakarzinom · Screening · Risikofaktor · Brustparenchym, dichtes · Ultraschall Zusammenfassung Die Diagnostik des Mammakarzinoms hat durch die Entwicklung der modernen, hochauflösenden Mammasonografie bedeutende Fortschritte erzielt. Ursprünglich nur zur Differenzierung zwischen zystischen und soliden Raumforderungen eingesetzt, dient der Ultraschall mittlerweile zur Verbesserung der Differenzialdiagnostik zwischen gutartigen und bösartigen Tumoren, zum präoperativen lokalen Staging und zur interventionellen Diagnostik. Bei jungen Frauen und dichtem Brustparenchym weist die Mammografie eine erhebliche diagnostische Lücke auf. Außerdem haben Frauen mit dichtem Parenchym ein deutlich erhöhtes Krebserkrankungsrisiko. Ultraschall eignet sich sehr gut, um dichtes Brustgewebe zu untersuchen. Mehrere Studien zeigen, dass die hochauflösende Sonografie bei diesen Frauen zusätzlich 3-4 Karzinome pro 1000 Frauen mit unauffälligem klinischen und mammografischen Befund entdecken kann. Die Stadienverteilung ist dabei ähnlich günstig wie bei der mammografischen Früherkennung. In der kurativen Diagnostik wird der Ultraschall häufig eingesetzt, um die diagnostischen Probleme der Mammografie zu kompensieren. Im Rahmen des bundesweiten Mammografiescreenings wird die Brustdichte aber bislang nicht berücksichtigt. Der Ultraschall kommt nur zum Einsatz, wenn mammografisch ein verdächtiger Befund vorliegt. Interessanterweise wurde in Österreich vor 2 Jahren ein Screeningprojekt begonnen, in dem bei mammografisch dichter Brust Ultraschall eingesetzt wird. Die vorläufigen Auswertungen zeigen eine Steigerung der Karzinomerkennung in derselben Größenordnung wie in den früheren Studien. Daher ist eine Verbesserung der Brustkrebsdiagnostik durch die systematische Anwendung der Ultraschalldiagnostik zu erwarten.
World Journal of Surgical Oncology, 2011
Background: Ultrasound-guided diagnostic breast biopsy technology represents the current standard of care for the evaluation of indeterminate and suspicious lesions seen on diagnostic breast ultrasound. Yet, there remains much debate as to which particular method of ultrasound-guided diagnostic breast biopsy provides the most accurate and optimal diagnostic information. The aim of the current study was to compare and contrast the 8gauge vacuum-assisted biopsy approach and the spring-loaded 14-gauge core biopsy approach. Methods: A retrospective analysis was done of all ultrasound-guided diagnostic breast biopsy procedures performed by either the 8-gauge vacuum-assisted biopsy approach or the spring-loaded 14-gauge core biopsy approach by a single surgeon from July 2001 through June 2009. Results: Among 1443 ultrasound-guided diagnostic breast biopsy procedures performed, 724 (50.2%) were by the 8-gauge vacuum-assisted biopsy technique and 719 (49.8%) were by the spring-loaded 14-gauge core biopsy technique. The total number of false negative cases (i.e., benign findings instead of invasive breast carcinoma) was significantly greater (P = 0.008) in the spring-loaded 14-gauge core biopsy group (8/681, 1.2%) as compared to in the 8-gauge vacuum-assisted biopsy group (0/652, 0%), with an overall false negative rate of 2.1% (8/386) for the spring-loaded 14-gauge core biopsy group as compared to 0% (0/148) for the 8-gauge vacuum-assisted biopsy group. Significantly more (P < 0.001) patients in the spring-loaded 14-gauge core biopsy group (81/719, 11.3%) than in the 8-gauge vacuum-assisted biopsy group (18/724, 2.5%) were recommended for further diagnostic surgical removal of additional tissue from the same anatomical site of the affected breast in an immediate fashion for indeterminate/inconclusive findings seen on the original ultrasound-guided diagnostic breast biopsy procedure. Significantly more (P < 0.001) patients in the spring-loaded 14-gauge core biopsy group (54/719, 7.5%) than in the 8-gauge vacuum-assisted biopsy group (9/724, 1.2%) personally requested further diagnostic surgical removal of additional tissue from the same anatomical site of the affected breast in an immediate fashion for a benign finding seen on the original ultrasound-guided diagnostic breast biopsy procedure. Conclusions: In appropriately selected cases, the 8-gauge vacuum-assisted biopsy approach appears to be advantageous to the spring-loaded 14-gauge core biopsy approach for providing the most accurate and optimal diagnostic information.
2015
Background: Mammography has been used widely for breast cancer screening. However, the false-negative rate of mammography is 35%. Breast ultrasonography (USG) is the most common method used for additional screening. Performing routine breast ultrasonography (USG) with mammography is still a matter of debate. In our study, it has been aimed to determine the value of adding breast ultrasonography (USG) on the suspicious breast masses. Material and Methods: In our study, 121 breast lesions were evaluated in 104 patients. Files and images of patients were analyzed retrospectively. Patients who underwent mammography and ultrasound imaging were included in the study. Lesions were categorized in accordance with the Breast Imaging Reporting and Data System (BIRADS) classification. Patients were divided into two groups (under and above 45 years of age), and sensitivity and specificity rates of mammography and USG were compared. Results: Mammography of 27 patients with malignant masses was re...
Journal of Medical Oncology and Therapeutics, 2016
Background: To determine concordant or discordant breast biopsy results and see their effect on patient management and outcome. Material and methods: This descriptive analytical study was conducted at the department of Diagnostic Radiology Aga Khan University Hospital Karachi Pakistan from January to December 2013. All patients fulfilling our selection criteria were included. A concordant result was defined when the imaging and pathology results concluded same diagnosis and a discordant result when they did not match. All histopathology results were reviewed and a decision was made regarding concordant/discordant biopsy results and recommendations given for further management of all patients. Results: A total of 282 patients underwent core biopsy of lesions in the breast. The mean age was 47.87 ± 13.99 years. Out of 282 lesions biopsied, 172 were concordant malignant and 105 were concordant benign. Two lesion out of 282 were borderline or high risk, one case was discordant benign and 2 cases discordant malignant. The appropriate management for all cases was recommended after radiology-pathology correlation. Conclusion: Cautious Radiology-Pathology co relation is indispensable in addition to appropriate post biopsy management for managing a successful core breast biopsy program. This practice identifies a substantial number of false negative results of core biopsy by identifying discordant results avoiding delays in diagnosis of breast cancer.